Posterolateral Fusion Versus Posterior Lumbar Interbody Fusion: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.

Autor:	Said E; Department of Orthopedics and Traumatology, 113328Qena Faculty of Medicine, South Valley University, Egypt., Abdel-Wanis ME; Department of Orthopedics and Traumatology, Sohag 68890Faculty of Medicine, Sohag University, Egypt., Ameen M; Department of Orthopedics and Traumatology, 113328Qena Faculty of Medicine, South Valley University, Egypt., Sayed AA; Department of Orthopedics and Traumatology, 113328Qena Faculty of Medicine, South Valley University, Egypt., Mosallam KH; Department of Orthopedics and Traumatology, 113328Qena Faculty of Medicine, South Valley University, Egypt., Ahmed AM; Department of Orthopedics and Traumatology, 113328Qena Faculty of Medicine, South Valley University, Egypt., Tammam H; Department of Orthopedics and Traumatology, 113328Qena Faculty of Medicine, South Valley University, Egypt.
Jazyk:	angličtina
Zdroj:	Global spine journal [Global Spine J] 2022 Jun; Vol. 12 (5), pp. 990-1002. Date of Electronic Publication: 2021 May 12.
DOI:	10.1177/21925682211016426
Abstrakt:	Study Design: Systematic review and meta-analysis. Objectives: Arthrodesis has been a valid treatment option for spinal diseases, including spondylolisthesis and lumbar spinal stenosis. Posterolateral and posterior lumbar interbody fusion are amongst the most used fusion techniques. Previous reports comparing both methods have been contradictory. Thus, we conducted a systematic review and meta-analysis of randomized controlled trials (RCTs) to establish substantial evidence on which fusion method would achieve better outcomes. Methods: Major databases including PubMed, Embase, Web of Science and CENTRAL were searched to identify studies comparing outcomes of interest between posterolateral fusion (PLF) and posterior lumbar interbody fusion (PLIF). We extracted data on clinical outcome, complication rate, revision rate, fusion rate, operation time, and blood loss. We calculated the mean differences (MDs) for continuous data with 95% confidence intervals (CIs) for each outcome and the odds ratio with 95% confidence intervals (CIs) for binary outcomes. P < 0.05 was considered significant. Results: We retrieved 8 studies meeting our inclusion criteria, with a total of 616 patients (308 PLF, 308 PLIF). The results of our analysis revealed that patients who underwent PLIF had significantly higher fusion rates. No statistically significant difference was identified in terms of clinical outcomes, complication rates, revision rates, operation time or blood loss. Conclusions: This systematic review and meta-analysis provide a comparison between PLF and PLIF based on RCTs. Although PLIF had higher fusion rates, both fusion methods achieve similar clinical outcomes with equal complication rate, revision rate, operation time and blood loss at 1-year minimum follow-up.
Databáze:	MEDLINE
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